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Medical School Applications Rise, With Diversity Gains Noted

By John Reichard, CQ HealthBeat Editor

October 29, 2014 -- Applications to medical school rose 3.1 percent in 2014 while enrollment increased 1.4 percent to an all-time high of 20,343, the Association of American Medical Colleges (AAMC) announced last week.

Interest was particularly strong in the Hispanic population, where the number of applicants increased 9.7 percent, to 4,386. The number of applications by African-American candidates rose by 3.2 percent.

AAMC officials said it's time for Congress to increase residency training positions for aspiring doctors, adding diversity in the nation's medical schools was on the rise.

The lobby wants Congress to lift a 17-year cap on residency training slots that was written into the Balanced Budget Act (PL 105-33). The group says predicts there will be a shortage of 130,600 physicians by 2025 as baby boomer generation ages. Medical school capacity has increased, with a new school at Western Michigan University in Kalamazoo, among other communities. But the number of residency slots has been capped at 26,000.

"I don't see much of anything being done in this Congress" to lift the cap, Atul Grover, chief public policy officer at AAMC, said in an interview.

Grover said Congress could address the issue during a lame duck session if it also moved to permanently scrap the formula Medicare uses to pay physicians. That is considered a long shot, because lawmakers have yet to agree on a way to offset the estimated $150 billion 10-year cost of replacing the formula.

Grover says three bills in Congress would increase the number of residency slots by 15 percent over the next five years, thereby allowing 3,000 to 4,000 more doctors per year to be trained.

Democratic Senators Harry Reid of Nevada, Charles E. Schumer of New York, and Bill Nelson of Florida are backing one bill (S 577), while Rep. Joseph Crowley, D-N.Y., has introduced a measure (HR 1180) in the House. Reps. Allyson Schwartz, D-Pa., and Aaron Schock, R-Ill. have a bill (HR 1201) that in addition to increasing slots would reduce Medicare Graduate Medical Education payments by 2 percent if schools didn't meet certain training standards for team-based care or the use of information technology, for example.

Grover estimates that all three bills would add a total of $10 billion over 10 years to Medicare spending. Though that represents a small piece of overall program spending, he acknowledged, "we can't even find a billion bucks here and there to do anything these days."

"We certainly have a commitment from various House and Senate offices to continue working on the legislation in the next Congress. The real challenge is where are we in terms of our willingness to invest further in health care."

"Medical schools understand that an effective physician workforce is a diverse workforce," said AAMC President Darrell Kirch.

On diversity, applications were up not only among Hispanics but also among American Indians and Alaska Natives. The total among those groups rose 17 percent from 173 in 2013 to 202 in 2014. Grover said the increase in applications by Hispanic students probably reflected the increasing size of the Hispanic population.

But small percentage increases in enrollment by minorities still left them under-represented among new medical school students, with the exception of Asian Americans. Hispanics accounted for 9 percent of new enrollees and African Americans 7 percent, Women accounted for 48 percent of students enrolling in medical school in 2014 and men 52 percent.

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